Effects of Synbiotic Supplementation on Chronic Inflammation and the Gut Microbiota in Obese Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

Abstract

The aim of this study was to investigate the effects of 24-week synbiotic supplementation on chronic inflammation and the gut microbiota in obese patients with type 2 diabetes. We randomized 88 obese patients with type 2 diabetes to one of two groups for 24 weeks: control or synbiotic (Lacticaseibacillus paracasei strain Shirota (previously Lactobacillus casei strain Shirota) and Bifidobacterium breve strain Yakult, and galactooligosaccharides). The primary endpoint was the change in interleukin-6 from baseline to 24 weeks. Secondary endpoints were evaluation of the gut microbiota in feces and blood, fecal organic acids, high-sensitivity C-reactive protein, lipopolysaccharide-binding protein, and glycemic control. Synbiotic administration for 24 weeks did not significantly affect changes in interleukin-6 from baseline to 24 weeks (0.35 ± 1.99 vs. −0.24 ± 1.75 pg/mL, respectively). Relative to baseline, however, at 24 weeks after synbiotic administration there were positive changes in the counts of Bifidobacterium and total lactobacilli, the relative abundances of Bifidobacterium species such as Bifidobacterium adolescentis and Bifidobacterium pseudocatenulatum, and the concentrations of acetic and butyric acids in feces. No significant changes in inflammatory markers were found in the synbiotic group compared to the control group. However, synbiotic administration at least partially improved the gut environment in obese patients with type 2 diabetes.

The Effect of Dietary Interventions on Chronic Inflammatory Diseases in Relation to the Microbiome: A Systematic Review

“…In total, 11 studies were performed with supplemental fiber interventions in both IBD and T2DM populations. Studies investigating <10 g/day of fiber supplementation did not show significant changes in disease-specific outcomes in T2DM patients [ 73 , 79 , 81 ]. Additionally, these interventions only resulted in changes in the microbiome when combined with a probiotic.…”

“…Additionally, these interventions only resulted in changes in the microbiome when combined with a probiotic. Specifically, Kanazawa et al found significantly more Lactobacillus and Bifidobacterium in the synbiotic group (containing Lactobacillus parasei , Bifidobacterium breve , and 7.5 g/day of GOS) compared to placebo, as well as a significant increase in Akkermansia muciniphilia compared to baseline [ 81 ]. Horvath et al also explored the effects of a synbiotic ( Lactobacillus and Bifidobacterium spp.…”

“…Overall, 70% of the high-fiber dietary interventions showed a beneficial shift of the microbiome by increasing diversity, increasing the abundance of SCFA-producing bacteria, and/or decreasing pathogenic bacteria [ 56 , 57 , 58 , 62 , 63 , 66 , 67 , 69 , 70 ]. Of the fiber supplement interventions, six of the 11 studies showed an overall beneficial shift of the microbiome, of which three were synbiotic interventions [ 59 , 60 , 75 , 76 , 78 , 79 , 81 ]. Both low-FODMAP studies negatively affected the microbiome, while two other low-fiber diets showed some beneficial shifts [ 52 , 53 , 54 , 55 ].…”

Maternal Obesity Related to High Fat Diet Induces Placenta Remodeling and Gut Microbiome Shaping That Are Responsible for Fetal Liver Lipid Dysmetabolism

“…LEfSe analysis is performed to identify differences in flora and types of microorganisms between groups, which aids the development of biomarkers ( 17 ). The size of the different species is represented by the length of the histogram (i.e., LDA score) ( 28 ). The histogram revealed that HF dams (red) had more of the Romboutsia genus and Akkermansia genus than did the CC dams (green).…”

Microbiota and body weight control: Weight watchers within?

“…Lactis W58 and Lc. Lactis W19 + Omnilogic Plus : GOS P11, FOS P6, konjac glucomannan P13 (E425), calcium carbonate (E170), zinc citrate 3-hydrate, vitamin D3 (cholecalciferol) and vitamin B2 (riboflavin) (E101) and a matrix containing maltodextrin, natural elderflower flavouring and Gum Arabic (E414) 1.5 × 10 10 CFU total + 8 g/day Obese adults with T2D 6 months = = ↓ hip circumference, ↓ zonulin, ↑ QoL (physical functioning), = glucose metabolism [ 288 ] L. acidophilus, B. lactis, B. longum, B. bifidum + GOS 15 × 10 9 CFU + 5.5 g/day Overweight/obese humans that underwent weight loss program 3 months ↑richness, ↑ Bifidobacterium , ↑ Lactobacillus , ↓ Prevotella , ↓ Gardnerella = = [ 289 ] L. acidophilus, B. lactis, B. bifidum, B. longum + inulin 1.5 × 10 10 CFU each +6 g/day Overweight or obese people with prediabetes 6 months = Not reported =food intake [ 278 ] 2 Bifidobaterium +5 Lactobacillus strains + FOS + inulin 1 × 10 9 /g (total) + 9.6 g + 110.4 g Overweight/obese humans 3 months ↑ Lactobacillus , ↑ E. coli , ↑ Enterococcus = Not measured [ 290 ] L. casei , L. paracasei , B. breve + GOS 3 × 10 8 CFU each + 7.5 g daily Obese humans with T2D 24 weeks ↑ Bifidobacterium , ↑ Lactobacillus , ↑ B. adolescentis , ↑ B. pseudocatenulatum = ↑ acetic and butyric acids in faeces [ 291 ] This table summarises recent studies, examining the unique effect of microbiota modifications on body weight and gut microbiota composition in people with ove...…”